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Record W2069874374 · doi:10.1136/bmj.322.7290.851

External assessment of health care

2001· review· en· W2069874374 on OpenAlex

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

affAt least one author lists a Canadian institution in the pinned OpenAlex snapshot.

Bibliographic record

VenueBMJ · 2001
Typereview
Languageen
FieldHealth Professions
TopicHealthcare Quality and Management
Canadian institutionsCentre de Santé et de Services Sociaux Cavendish
Fundersnot available
KeywordsAccountabilityTransparency (behavior)BusinessHealth carePopulationIncentiveRisk analysis (engineering)Public relationsMedicineComputer scienceComputer securityEnvironmental healthEconomicsPolitical science

Abstract

fetched live from OpenAlex

A rash of external inspection is affecting the delivery of health care around the world. Governments, consumers, professions, managers, and insurers are hurrying to set up new schemes to ensure public accountability, transparency, self regulation, quality improvement, or value for money. But what do we know of such schemes' evidence base, the validity of their standards, the reliability of their assessments, or their ability to bring improvements for patients, staff, or the general population? ### Box 1: Characteristics of effective external assessment programmes Give clear framework of values —To describe elements of quality, and their weighting, such as the enablers and results defined by the European Foundation for Quality Management Publish validated standards —To provide an objective basis for assessment Focus on patients —To reflect horizontal clinical pathways rather than vertical management units Include clinical processes and results —To reflect perceptions of patients, staff, and public Encourage self assessment —To give time and tools to internalise assessment and development Train the assessors —To promote reliable assessments and reports Measure systematically —To describe and weight compliance with standards objectively Provide incentives —To give leverage for improvement and response to recommendations Communicate with other programmes —To promote consistency and reciprocity and to reduce duplication and burden of inspection Quantify improvement over time —To demonstrate effectiveness of programme Give public access to standards, assessment processes, and results —To be transparent and publicly accountable RETURN TO TEXT In short, not much. The standards, measurements, and results of management systems have not been, and largely cannot be, subjected to the same rigorous scrutiny and meta-analysis as clinical practice. No one has published a controlled trial, and there are too many confounding variables to prove that inspection causes better clinical outcomes, although there is evidence that organisations increase their compliance with standards if these are made explicit. But experience and consensus are gradually being codified into guidelines to …

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.004
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: none
GenreCandidate signal: Review · Consensus signal: Review
Teacher disagreement score0.905
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0040.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0020.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0010.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.473
GPT teacher head0.682
Teacher spread0.209 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it